Prescription pattern of antibiotics in paediatric inpatients at a tertiary care hospital in North East India

Background: Paediatric antibiotic prescription is a major concern in terms of public health since infections are the most frequent cause of childhood disease. The aim of this hospital-based cross sectional study was to assess the pattern of antibiotic use in the paediatric ward of RIMS hospital, Manipur, India.Methods: A retrospective study of six months duration was carried out for the month of October 2016 to March 2017. A total number of 200 patients case sheets were utilized for our study from paediatric in-patients department of RIMS hospital, Manipur. The data collected was then analysed for various prescribing indicators as laid down by world health organisation (WHO) for analysis of drug use parameters.Results: The mean age of paediatric patient was 2.1 years. The average number of drugs per encounter was 5.14. The average number of antibiotic per patient was 2.11. In present study antibiotic were 41% of total drugs prescribed. Most common prevalence of disease among study patients sample was acute gastroenteritis. The most commonly prescribed antibiotic was Ceftriaxone followed by Amikacin. In present study 8.2% of antibiotics were prescribed in generic name. Polypharmacy was evident from the study.Conclusions: Antibiotic prescribing in children is relatively high in RIMS, Imphal, Manipur. Prescription of broad-spectrum antibiotics though has increased demonstrably which h may result in development of bacterial resistance; however, development of guidelines for antibiotic prescription and use of appropriate drugs for the disease can result in minimizing the unfavourable use of antibiotics in children.

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Study of antimicrobial use in paediatric inpatients in a tertiary care hospital in Ahmedabad, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20205430 ◽

2020 ◽

Vol 8 (1) ◽

pp. 35

Author(s):

Hetal N. Jeeyani ◽

Rutvik H. Parikh ◽

Sheena Sivanandan ◽

Harsh J. Muliya ◽

Shivam N. Badiyani ◽

...

Keyword(s):

Bacterial Resistance ◽

Tertiary Care ◽

Antibiotic Use ◽

Antibiotic Prescribing ◽

Care Hospital ◽

Antimicrobial Drugs ◽

Prescribing Indicators ◽

Inappropriate Use ◽

Increased Risk ◽

The Mean

Background: Inappropriate use and overuse of antibiotics are important factors leading to increased bacterial resistance apart from increased risk of adverse reactions. The aim of this study was to derive antibiotic use percentage, study its pattern and compare antibiotic prescribing indicators with standard indicators.Methods: This prospective observational study was conducted from 1st August 2018 to 31st July 2019 on paediatric inpatients from 1 month to 14 years. All the relevant data was taken from the case records of patients at the time of discharge. The data included: age, sex, hospital stay, clinical diagnosis and details of antimicrobial treatment.Results: From 989 patients, 85.9% were diagnosed with infectious illness, of which 60.1% had viral and 36.7% had bacterial infection. The use of antimicrobial drugs was 42.7% and antibiotics was 40.4%. The mean number of antibiotics received was 1.13±0.31. 90% patients received single antibiotic. 88.8% drugs were prescribed by generic name and 99% drugs were prescribed from essential drug formulary. 17 different antibiotics were used out of which ceftriaxone (62.5%) was the most commonly used. Groupwise, antibiotic use was cephalosporins (68.4%), penicillin (20.2%), aminoglycosides (4.31%), fluoroquinolones (0.9%) and macrolides (0.22%). The use of higher antibiotics like vancomycin (3.86%) and carbapenems (0.68%) was quite less.Conclusions: The antibiotic use in our hospital was higher than the WHO standard but less as compared to majority of other studies. Use of cephalosporins was more and penicillin was less as compared to other studies. This suggests that there is a need of implementing antibiotic stewardship programs to enhance rational antibiotic prescribing.

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Trends in Antibiotic Self-Medication for Dental Pathologies among Patients in the Dominican Republic: A Cross-Sectional Study

Journal of Clinical Medicine ◽

10.3390/jcm10143092 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3092

Author(s):

Juan Manuel Aragoneses ◽

Javier Aragoneses ◽

Cinthia Rodríguez ◽

Juan Algar ◽

Ana Suárez

Keyword(s):

Dominican Republic ◽

Clavulanic Acid ◽

Bacterial Resistance ◽

Antibiotic Use ◽

World Health Organisation ◽

World Health ◽

Binary Logistic Regression Analysis ◽

Self Medication ◽

Cross Sectional ◽

Amoxicillin Clavulanic Acid

The World Health Organisation has warned of the increase in antibiotic resistance, estimating that by 2050 it could become the leading cause of death worldwide. Several studies and literature reviews show a correlation between antibiotic use and bacterial resistance, with unnecessary broad-spectrum antibiotics, such as amoxicillin/clavulanic acid and azithromycin, being one of the main causative factors. An interview-based survey of 2160 participants was conducted to assess the prevalence in the practice of self-medication with antibiotics among dental patients in the Dominican Republic. A series of open-ended questions regarding self-medication and class of antibiotics were put to the patients. Over a third of the study population (39.7%) admitted to the practice of antibiotic self-medication. Most of the respondents (58.4%) who indulged in self-medication were females, and it was prevalent in the older adults between 32–42 years old (36%). There was a negative correlation between age and self-medication practice (p < 0.001) observed with point biserial correlation test. Binary logistic regression analysis found an odds ratio of 0.97 (p < 0.001). The most consumed antibiotics were amoxicillin/clavulanic acid (52%), amoxicillin (31.1%), and azithromycin (10.1%). It is imperative to educate patients about the harmful effects of self-medication and to stress the need for governments to implement stricter laws on non-prescription drug availability.

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Antibiotic utilization pattern in the department of surgery in a tertiary care centre in eastern India

International Surgery Journal ◽

10.18203/2349-2902.isj20195126 ◽

2019 ◽

Vol 6 (11) ◽

pp. 4080

Author(s):

Archana Dipa Sangita Kujur ◽

Nishith M. Paul Ekka ◽

Satish Chandra

Keyword(s):

Bacterial Resistance ◽

Antibiotic Prescription ◽

Tertiary Care ◽

Study Data ◽

Prescribing Patterns ◽

Antibiotic Prescribing ◽

Medical Sciences ◽

Tertiary Care Centre ◽

Prevalence Survey ◽

Cross Sectional

Background: The overuse and volume of antibiotic prescription has been found to correlate to the incidence of bacterial resistance. Clinical audit and education can favourably change antibiotic prescribing patterns among practitioners.Methods: Prospective cross-sectional prevalence survey carried out in inpatient department (IPD) and outpatient department (OPD) of department of Surgery, Rajendra Institute of Medical Sciences, Ranchi. 200 prescriptions from OPD and 200 case sheets from IPD were randomly selected. Data was analyzed as per WHO outpatient prescribing indicators. ICU patients and patients on anti-tubercular treatment, antifungals etc. were excluded from this study. Data were computed and analyzed using MS Excel.Results: In the OPD, the average no of drugs per patient was 3.445 of which 17% were injections. 33% of drugs prescribed were antibiotics. Beta-lactams followed by nitroimidazoles were the most common antibiotic class. In the IPD, an average of 2.26 antibiotics per patients was prescribed. 21% of antibiotics were prescribed by a generic name and 196 patients received antibiotic prophylaxis. β-lactams again were the most commonly prescribed antibiotic class with 42.7% (n=193) of total antibiotics prescriptions, Metronidazole (n=101, 22.37%) was the most prescribed antimicrobial agent.Conclusions: The practice of polypharmacy and high antibiotic prescription rate is a concern in our part of the country. Prescriptions writing in generic name needs to be encouraged. There is an acute need for the development of antibiotics prescribing guidelines in India.

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Critical appraisal of drug promotional literature using World Health Organisation guidelines

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20173289 ◽

2017 ◽

Vol 6 (8) ◽

pp. 2014

Author(s):

Sandhya Rani Gautam ◽

Preeta Kaur Chugh ◽

Ravinder Kr. Sah ◽

C. D. Tripathi

Keyword(s):

Tertiary Care ◽

World Health Organisation ◽

Cross Sectional Study ◽

Primary Objective ◽

World Health ◽

Pharmaceutical Companies ◽

Care Hospital ◽

Who Guidelines ◽

Ethical Guidelines ◽

Cross Sectional

Background: Pharmaceutical marketing using drug promotional literatures is an important strategy adopted by the companies to promote their drugs. The primary objective of the present study is to compare the drug promotional literature of different pharmaceutical companies on the basis of World Health Organization (WHO) guidelines on ethical drug promotion.Methods: This observational, cross sectional study was conducted at a tertiary care hospital, Delhi. The promotional literature was evaluated in accordance with WHO guidelines, nature of claims, pictorial content presented in it and for the cited references.Results: A total of 208 promotional brochures were analysed. Only few (5.8%) of the promotional literature fulfilled all the criteria as mentioned by the guidelines. Nutritional supplements (27.9%) were the most promoted group of drugs. Pharmaceutical companies were most reluctant to provide information regarding contraindications (9.6%), adjuvants (11.5), side effects (10.6%) and drug interactions (9.6%). Generic name, brand name, dosage form, therapeutic indications were outlined in most of the brochures. Exaggerated emotional claims were made in 47.1% brochures, followed by that of efficacy in 39.4% and safety in 25% of brochures. Pictures of medicinal products outnumbered others with 39.9% followed by pictures of women, children and doctors with 20.7%, 17.3% and 13.5% respectively.Conclusions: Majority of the drug promotional literature did not comply with the ethical guidelines and was inadequate in terms of their adequacy, quality and reliability. Hence, it can be concluded that the majority of the promotional advertisements that are given to the prescribers are not able to spread awareness towards rational prescribing.

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Trends and patterns of antibiotic prescribing at orthopedic inpatient departments of two private-sector hospitals in Central India: A 10-year observational study

PLoS ONE ◽

10.1371/journal.pone.0245902 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245902

Author(s):

Kristina Skender ◽

Vivek Singh ◽

Cecilia Stalsby-Lundborg ◽

Megha Sharma

Keyword(s):

Design Patterns ◽

Central India ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Prescribing Patterns ◽

Essential Medicines ◽

World Health ◽

Antibiotic Prescribing ◽

Cross Sectional ◽

Defined Daily Doses

Background Frequent antibiotic prescribing in departments with high infection risk like orthopedics prominently contributes to the global increase of antibiotic resistance. However, few studies present antibiotic prescribing patterns and trends among orthopedic inpatients. Aim To compare and present the patterns and trends of antibiotic prescription over 10 years for orthopedic inpatients in a teaching (TH) and a non-teaching hospital (NTH) in Central India. Methods Data from orthopedic inpatients (TH-6446; NTH-4397) were collected using a prospective cross-sectional study design. Patterns were compared based on the indications and corresponding antibiotic treatments, mean Defined Daily Doses (DDD)/1000 patient-days, adherence to the National List of Essential Medicines India (NLEMI) and the World Health Organization Model List of Essential Medicines (WHOMLEM). Antibiotic prescriptions were analyzed separately for the operated and the non-operated inpatients. Linear regression was used to analyze the time trends of antibiotic prescribing; in total through DDD/1000 patient-days and by antibiotic groups. Results Third generation cephalosporins were the most prescribed antibiotic class (TH-39%; NTH-65%) and fractures were the most common indications (TH-48%; NTH-48%). Majority of the operated inpatients (TH-99%; NTH-97%) were prescribed pre-operative prophylactic antibiotics. The non-operated inpatients were also prescribed antibiotics (TH-40%; NTH-75%), although few of them had infectious diagnoses (TH-8%; NTH-14%). Adherence to the NLEMI was lower (TH-31%; NTH-34%) than adherence to the WHOMLEM (TH-65%; NTH-62%) in both hospitals. Mean DDD/1000 patient-days was 16 times higher in the TH (2658) compared to the NTH (162). Total antibiotic prescribing increased over 10 years (TH-β = 3.23; NTH-β = 1.02). Conclusion Substantial number of inpatients were prescribed antibiotics without clear infectious indications. Adherence to the NLEMI and the WHOMLEM was low in both hospitals. Antibiotic use increased in both hospitals over 10 years and was higher in the TH than in the NTH. The need for developing and implementing local antibiotic prescribing guidelines is emphasized.

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Antimicrobial prescribing patterns in surgical inpatient of tertiary care hospital in Eastern India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20193199 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1902

Author(s):

Sumit Kumar Gupta ◽

Siddhartha Ghosh

Keyword(s):

Tertiary Care ◽

Relevant Information ◽

Prescribing Patterns ◽

Antibiotic Prescribing ◽

Antibiotic Administration ◽

Care Hospital ◽

Beta Lactam ◽

Cross Sectional ◽

Before And After ◽

Surgery Department

Background: Antimicrobials form the cornerstone of prescriptions for treating infection. Surgical management cannot be possible without the use of antibiotics. Severity of infection, suspected spectrum of organisms and their sensitivity, co-morbidities of the patient, route of antibiotic administration are the important parameter to consider before selecting antibiotic.Methods: Cross-sectional, hospital based, descriptive study was conducted in the ward of Surgery Department of IQ City Medical college, Durgapur over a period of 1 year. The relevant information was entered into the pretested preformats (containing name, age, sex, diagnosis, ongoing treatment as recorded from patients’ prescription slips or CRFs) and analyzed. Necessary permission was granted by the Institutional Ethical Committee and written informed consent was obtained from the patients prior to collecting their prescription slips/CRF.Results: Commonest cause of hospitalization was cholelithiasis (318 (32.7%)). Antimicrobials were the most commonly prescribed drugs (1626 (31.6%)). Single antibiotic prescribing frequency are similar to two antibiotic prescribing (both 44%). Piperacillin+Tazobactum combination most commonly prescribe antibiotic.Conclusions: Beta lactam antibiotic specifically Piperacillin (ATC class: J01D) were the most commonly prescribed antibiotic agents both before and after surgical procedures.

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Incidence and Risk Factors for Severe Dehydration in Hospitalized Children in Ujjain, India

10.20944/preprints201912.0205.v2 ◽

2020 ◽

Author(s):

Abhishek Sharma ◽

Aditya Mathur ◽

Cecilia Stålsby Lundborg ◽

Ashish Pathak

Keyword(s):

Risk Factors ◽

Tertiary Care ◽

World Health ◽

Respiratory Pattern ◽

Care Hospital ◽

Severe Dehydration ◽

Cross Sectional ◽

Oral Rehydration ◽

History Of ◽

Independent Risk Factors

Diarrhoea contributes significantly in the under-five childhood morality and mortality worldwide. This cross-sectional study was carried out in a tertiary care hospital in Ujjain, India from July 2015 to June 2016. Consecutive children aged 1 month to 12 years having “some dehydration” and “dehydration” according to World Health Organization classification were eligible to be included in the study. Other signs and symptoms used to assess severe dehydration were capillary refill time, urine output, and abnormal respiratory pattern. A questionnaire was administered to identify risk factors for severe dehydration, which was the primary outcome. Multivariate logistic regression modeling was used to detect independent risk factors for severe dehydration. The study included 332 children, with mean ± standard deviation age of 25.62 ± 31.85 months; out of which, 70%(95% confidence interval [CI] 65 to 75) were diagnosed to have severe dehydration. The independent risk factors for severe dehydration were: child not exclusive breast fed in the first six months of life (AOR 5.67, 95%CI 2.51 to 12.78; p<0.001), history of not receiving oral rehydration solution before hospitalization (AOR 1.34, 95%CI 1.01 to 1.78; p=0.038), history of not receiving oral zinc before hospitalization (AOR 2.66, 95%CI 1.68 to 4.21; p<0.001) and living in overcrowded conditions (AOR 5.52, 95%CI 2.19 to 13.93; p<0.001). The study identified many risk factors associated with severe childhood dehydration; many of them are modifiable though known and effective public health interventions.

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A STUDY OF THE ANTIBIOTIC PRESCRIPTION PATTERN AMONG THE INDOOR PATIENTS IN THE MEDICINE DEPARTMENT OF A TERTIARY CARE HOSPITAL IN NORTH EAST INDIA

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2018/124 ◽

2018 ◽

Vol 5 (7) ◽

pp. 605-608

Author(s):

Indrani Bhagawati ◽

Bhaskarjyoti Thakuria

Keyword(s):

Tertiary Care Hospital ◽

Antibiotic Prescription ◽

Tertiary Care ◽

Care Hospital ◽

Medicine Department ◽

Prescription Pattern ◽

North East India ◽

North East

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PRESCRIPTION PATTERN OF PSYCHOTROPIC DRUGS IN A PSYCHIATRY OPD OF A TERTIARY CARE HOSPITAL – A CROSS SECTIONAL STUDY.

10.36106/gjra/4813714 ◽

2021 ◽

pp. 191-194

Author(s):

Kishore M S ◽

Narendra Kumar ◽

S Sindhu

Keyword(s):

Psychotropic Drugs ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Cross Sectional Study ◽

World Health ◽

Fixed Dose ◽

Care Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Prescription Pattern

Background: The expanding and challenging eld of psychopharmacology is constantly seeking new and improved drugs to treat psychiatric disorders. Psychotropic drugs utilization in actual clinical practice, effectiveness and safety in the real-life situation needs continuous study. Therefore, the study was undertaken to analyze the prescription pattern of psychotropic drugs. Methods: A Cross sectional study was conducted in the psychiatry out-patient department of a tertiary care hospital for 4 months. Diagnosis was made according to ICD-10 criteria. Prescription pattern was analyzed using World Health Organization (WHO) drug indicators. Results: Psychotropic drugs constituted 74.85% of the prescribed medication. Average number of the psychotropic drugs per prescription was 2.53. Percentage of prescriptions with injectable drugs accounted for 5.13%. 59.28% of the drugs were prescribed by generic names, while the rest were branded. 28% of prescriptions contained psychotropic FDCs (Fixed dose th combination). 78.65% of the drugs were from the WHO's 18 List of Essential Medicines. Among the total psychotropic drugs prescribed, antipsychotics (43.87%) were the most commonly prescribed class of drugs followed by antidepressants (23.32%), anxiolytics (22.13%) and the mood stabilizers (9.88%) were the least. Conclusions: Prescription pattern of the psychotropic drugs were in accordance to the recommendations of various treatment guidelines. Antipsychotics were the most commonly prescribed psychotropic drugs.

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